A/R Medicaid Specialist
3 weeks ago
WE ARE HIRING
Location:250 E Liberty Street Louisville, KY 40202
(Potential for remote work after completion of training and/or previous experience has been verified)
About UofL Health
UofL Health is a fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations, and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital. Affiliated with the University of Louisville School of Medicine, UofL Health is committed to providing patients with access to the most advanced care available. This includes clinical trials, collaboration on research and the development of new technologies to both save and improve lives. With more than 13,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. For more information on UofL Health, go to (url removed).
Job Summary:
This position requires thorough knowledge of the Uniformed Bill, Medicaid and Managed Medicaid billing, secondary deductible/coinsurance billing, and payer resources for follow up. Performs all duties related to timely and efficient billing and follow-up. Thorough understanding of Medicaid eligibility, benefits, determining primary payer, and covered benefits.
Responsibilities:
Monitor and resolve claims holding on discharged not final billed (DNFB) list.
Ensure all claims are filed electronically except for some paper claims.
Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
Follow up on unpaid Medicaid and Managed Medicaid claims in a timely manner.
High dollar accounts will have consistent follow up until the account has been resolved.
Responsible for reviewing and understanding explanation of benefits/remittance advice.
Ensure statements are generated for the patient responsibility amounts.
Utilize insurance websites to view and resolve claims.
Perform extensive account follow-up and provide analysis of problem accounts.
Document all follow up efforts in a clear and concise manner into the AR system.
Familiar with inpatient only procedure list and work with Revenue Cycle leadership to prevent denials
Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account
Ensure medical record requests are documented and submitted in a timely manner
Identify and report all trends that may provide insight into payment challenges.
Phone contact with patient, physician office, attorney, etc for additional information to process claims.
Work assigned accounts as directed while reaching daily productivity goals.
Complete tasks by deadline.
Attend seminars as requested.
Other duties as assigned.
Qualifications:
MINIMUM EDUCATION & EXPERIENCE
High School Diploma, or GED
1 year of patient registration, billing or equivalent experience
Working knowledge of medical and insurance terms is desirable.
KNOWLEDGE, SKILLS, & ABILITIES
Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
Knowledge of general insurance requirements.
Experience working directly with EOBs and contractual adjustments.
General computer knowledge, working with electronic filing.
Ability to communicate verbally/in writing with professionalism.
Ability to meet productivity expectations.
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